NUR 521 Exam 1 |96 Complete Questions and Answers
(Modules 1 – 3)
Why should APRNs have full prescriptive authority? - -limited prescriptive authority
causes barriers to quality, affordability and pt access to care
- lower income patients would benefit
-Schedule 1 drugs - -no accepted medical use, highest potential for abuse (LSD,
Herorin)
-Schedule 2 drugs - -high potential for abuse (morphine, codeine, norco)
-Schedule 3 drugs - -has potential for abuse (Tylenol with codeine, buprenorphine)
-Schedule 4 drugs - -has potential for abuse, but less than others (alprazolam,
phenobarbital)
-Schedule 5 drugs - -less abuse potential and has small amount of stimulant
-What components are necessary when writing a prescription? - -prescriber name,
license, contact information
DEA and NPI
pt name and DOB
pt allergies
indication for medication
dos, route, frequency (SIG)
number of tabs
refills
generic or not
-What factors should the APRN consider when refilling medications? - -Is this a new
medication?
Am I changing the dose frequently? S/e?
Follow up appointment?
-What is the benefit of collaboration during drug selection and prescription writing? -
-Pharmacists can help with additional information regarding drug interactions, assist
with dosing, and first-hand knowledge of formulary
-What information should be included in pt educational material? - -name, purpose,
dose, administration, a/e, storage, lab testing and why, interactions, duration
(what, when, where, why, how)
-What is the best way to promote positive outcomes with drug therapy? - -
Scheduled medication reviews with the pt to optimize medication regimens based on
pt experiences and needs
-absorption - -drugs movement from its site of administration into the blood
, -distribution - -drugs movement from the blood to the interstitial space of tissues and
into cells
-metabolism - -enzymatically mediated alteration of drug structure (breaking down)
-What is bioavailability? - -the amount of active drug that reaches the systemic
circulation from its site of administration
-Explain how the same drug manufactured by a different drug company can have
different absorption rates? - -The rate the drug is absorbed is influenced by physical
and chemical properties. drug companies use fillers and binders (inactive
ingredients) that change the bioavailability
-What happens when a patient takes a drug that is metabolized by P450 enzymes if
an inducing or an inhibiting drug is added to the current drug regimen? - -drugs
metabolized by P450 are substrates that occur in the liver. Inducing drugs increase
metabolism which DECREASES the effectiveness. Inhibiting slows down metabolism
and can INCREASE active drug accumulation leading to toxicity
-Agonist - -molecules that activate receptors
i.e dobutamine
-antagonist - -prevent receptor activation
i.e antihistamines block allergy producing receptors
-What are ways to minimize adverse effects? - -monitor kidney, liver, bone marrow
through labs
monitor s/s
FDA special alerts (black box warnings and med guides)
-What factors can contribute to medication errors? - -Prescribing practices
Oversight
Communication
-What is the purpose of genetic testing? - -study of the ways genetic variations
affect individual responses to drugs through alterations in genes that code for drug
metabolizing enzymes and drug receptors
-When are pregnant women most susceptible to teratogenic drugs? - -first trimester
-What are ways to minimize drug concentrations in breast milk? - -Dosing: avoid
long half life, avoid extended release, choose drugs excluded from milk (ionized or
protein bound)
FYI lipid soluble drugs enter breast milk rapidly
-What changes occur in organ function of older adults? - -altered pharmacokinetics
secondary to organ system degeneration
-What would you expect the renal function would be in infants related to drugs? - -
renal drug excretion is lower in infants due to kidneys not being fully developed
(Modules 1 – 3)
Why should APRNs have full prescriptive authority? - -limited prescriptive authority
causes barriers to quality, affordability and pt access to care
- lower income patients would benefit
-Schedule 1 drugs - -no accepted medical use, highest potential for abuse (LSD,
Herorin)
-Schedule 2 drugs - -high potential for abuse (morphine, codeine, norco)
-Schedule 3 drugs - -has potential for abuse (Tylenol with codeine, buprenorphine)
-Schedule 4 drugs - -has potential for abuse, but less than others (alprazolam,
phenobarbital)
-Schedule 5 drugs - -less abuse potential and has small amount of stimulant
-What components are necessary when writing a prescription? - -prescriber name,
license, contact information
DEA and NPI
pt name and DOB
pt allergies
indication for medication
dos, route, frequency (SIG)
number of tabs
refills
generic or not
-What factors should the APRN consider when refilling medications? - -Is this a new
medication?
Am I changing the dose frequently? S/e?
Follow up appointment?
-What is the benefit of collaboration during drug selection and prescription writing? -
-Pharmacists can help with additional information regarding drug interactions, assist
with dosing, and first-hand knowledge of formulary
-What information should be included in pt educational material? - -name, purpose,
dose, administration, a/e, storage, lab testing and why, interactions, duration
(what, when, where, why, how)
-What is the best way to promote positive outcomes with drug therapy? - -
Scheduled medication reviews with the pt to optimize medication regimens based on
pt experiences and needs
-absorption - -drugs movement from its site of administration into the blood
, -distribution - -drugs movement from the blood to the interstitial space of tissues and
into cells
-metabolism - -enzymatically mediated alteration of drug structure (breaking down)
-What is bioavailability? - -the amount of active drug that reaches the systemic
circulation from its site of administration
-Explain how the same drug manufactured by a different drug company can have
different absorption rates? - -The rate the drug is absorbed is influenced by physical
and chemical properties. drug companies use fillers and binders (inactive
ingredients) that change the bioavailability
-What happens when a patient takes a drug that is metabolized by P450 enzymes if
an inducing or an inhibiting drug is added to the current drug regimen? - -drugs
metabolized by P450 are substrates that occur in the liver. Inducing drugs increase
metabolism which DECREASES the effectiveness. Inhibiting slows down metabolism
and can INCREASE active drug accumulation leading to toxicity
-Agonist - -molecules that activate receptors
i.e dobutamine
-antagonist - -prevent receptor activation
i.e antihistamines block allergy producing receptors
-What are ways to minimize adverse effects? - -monitor kidney, liver, bone marrow
through labs
monitor s/s
FDA special alerts (black box warnings and med guides)
-What factors can contribute to medication errors? - -Prescribing practices
Oversight
Communication
-What is the purpose of genetic testing? - -study of the ways genetic variations
affect individual responses to drugs through alterations in genes that code for drug
metabolizing enzymes and drug receptors
-When are pregnant women most susceptible to teratogenic drugs? - -first trimester
-What are ways to minimize drug concentrations in breast milk? - -Dosing: avoid
long half life, avoid extended release, choose drugs excluded from milk (ionized or
protein bound)
FYI lipid soluble drugs enter breast milk rapidly
-What changes occur in organ function of older adults? - -altered pharmacokinetics
secondary to organ system degeneration
-What would you expect the renal function would be in infants related to drugs? - -
renal drug excretion is lower in infants due to kidneys not being fully developed
